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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

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Evaluation of the Becton-Dickinson rapid serum tube: does it provide a suitable alternative to lithium heparin plasma tubes?

Goce Dimeski1, 2 / Paul P. Masci3 / Manuela Trabi1, 4 / Martin F. Lavin4, 5 / John de Jersey1

1School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia

2Department of Chemical Pathology, Pathology Queensland, Princess Alexandra Hospital Ipswich Road, Woolloongabba, Queensland, Australia

3Center for Integrative Clinical and Molecular Medicine, School of Medicine, Southern Region, Faculty of Health Sciences, University of Queensland, Brisbane, Queensland, Australia

4Queensland Institute of Medical Research, Radiation Biology and Oncology, Brisbane, Queensland, Australia

5The University of Queensland Center for Clinical Research, Brisbane, Queensland, Australia

Corresponding author: Goce Dimeski, School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia Phone: +61-7-3240-5082, Fax: +61-7-3240-7070, ;

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 5, Pages 651–657, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.141, March 2010

Publication History

Received:
2009-08-19
Accepted:
2010-01-12
Published Online:
2010-03-11

Abstract

Background: Obtaining a suitable specimen for analysis in a timely manner is pivotal in clinical chemistry service provision. Serum is recognized as the preferred specimen for most assays, but because of time constraints for completion of clotting and an increasing number of patients on anti-coagulant therapy, latent clotting or no clotting is an outcome which can lead to errors and delay in delivery of critical results. Although lithium heparin plasma has unique problems, it has become an alternative in hospital-based laboratories.

Methods: The Becton-Dickinson (BD) rapid serum tube (RST) was evaluated in a hospital environment using a total of 53 participants, both healthy and anticoagulated, for 31 analytes against BD PST II and BD SST II tubes measured with Beckman DxC800 and DxI800 analyzers.

Results: Most results from the RST tube were comparable with those from the SST II tube. Potassium results were closer to the PST II plasma concentrations. Incomplete and latent clotting was encountered in the RST specimens from participants (cardiac and dialysis) who had received a total of >7000 units of heparin [activated partial thromboplastin time (APTT) >150 s], warfarin/heparin combination, and specimens from cardiac surgery patients who had received a total of >25,000 units of heparin (APTT >200 s) at the time of collection of specimens.

Conclusions: The RST tube provides a suitable alternative to lithium heparin plasma tubes for most patients in a hospital environment. However, latent clotting continued to occur in specimens collected from participants who had received high concentrations of anticoagulants.

Clin Chem Lab Med 2010;48:651–7.

Keywords: anticoagulants; latent clotting; plasma; rapid serum tube; serum

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